BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnosti...BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices.One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.展开更多
BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this uniq...BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.展开更多
BACKGROUND Human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The c...BACKGROUND Human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The coexistence of CE and HCC is exceedingly rare,and only several well-documented cases have been reported.In addition to this coexistence,there is no report of the coexistence of CE,HCC,and liver abscess to date.Herein,we aimed to report a case of coexistence of liver abscess,hepatic CE,and HCC.CASE SUMMARY A 65-year-old herdsman presented to the department of interventional therapy with jaundice,right upper abdominal distension and pain for 10 d.Laboratory test showed that he had positive results for HBsAg,HBeAb,HBcAb,and echino-coccosis IgG antibody.The test also showed an increased level of alpha fetopro-tein of 3400 ng/mL.An abdominal computed tomography(CT)scan revealed an uneven enhanced lesion of the liver at the arterial phase with enhancement and was located S4/8 segment of the liver.In addition,CT scan also revealed a mass in the S6 segment of the liver with a thick calcified wall and according to current guideline and medical images,the diagnoses of hepatic CE(CE4 subtype)and HCC were established.Initially,transarterial chemoembolization was performed for HCC.In the follow-up,liver abscess occurred in addition to CE and HCC;thus,percutaneous liver puncture drainage was performed.In the next follow-up,CE and HCC were stable.The liver abscess was completely resolved,and the patient was discharged with no evidence of recurrence.CONCLUSION This is the first reported case on the coexistence of liver abscess,hepatic CE,and HCC.Individualized treatment and multidisciplinary discussions should be performed in this setting.Therefore,treatment and diagnosis should be based on the characteristics of liver abscess,hepatic CE,and HCC,and in future clinical work,it is necessary to be aware of the possibility of this complex composition of liver diseases.展开更多
Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE)....Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE).Methods:A total of 128 pediatric inpatients with echinococcosis at the People’s Hospital of Qinghai Province and the Clinical Research Institute of Echinococcosis of Qinghai Province between January 2016 and December 2021 were chosen as subjects.Demographic and clinical data were collected,and double data entry was executed using EpiData 3.02.Factors influencing the cure of echinococcosis were analyzed with echinococcosis cure as the dependent variable,employing statistical analysis via SPSS 19.0.Results:Of the cases,35.9%had CE,and 64.1%had AE.Both types were observed in patients of all ages,with the majority aged 13-18.The number of cysts and their sizes varied between CE and AE.Complications were prevalent,including liver,gallbladder,lung,and nutritional complications.Univariate analyses revealed significant differences in outcomes based on factors such as cyst size(for CE),liver function grade(for AE),hydatid hypersensitivity test,operation,and length of hospital stay(P<0.05).Conclusion:This comprehensive analysis of hospitalized cases sheds light on the clinical data of echinococcosis in children and adolescents in Qinghai Province.The findings contribute to a scientific foundation for formulating effective prevention and control measures tailored to this demographic,facilitating an improved understanding of echinococcosis in Qinghai province.展开更多
Hepatic echinococcosis, also called echinococcosis, is a health-threatening disease commonly found in pasture, and belongs to parasitic zoonoses. The purpose of this study was to investigate the prevalence and the ris...Hepatic echinococcosis, also called echinococcosis, is a health-threatening disease commonly found in pasture, and belongs to parasitic zoonoses. The purpose of this study was to investigate the prevalence and the risk factors of echinococcosis in Qinghai province in order to provide fundamental data for prevention and control of echinococcosis in Qinghai province. A total of 23 445 people from 21 counties were enrolled in this study by multi-stage stratified random sampling. Echinococcosis was diagnosed by using B-mode ultrasonography and serological tests. The results showed that the prevalence of echinococcosis was 4.47%（95%CI： 4.21%–4.73%） and serum positive rate（seroprevalence） was 15.47%（95%CI： 14.92%–16.02%） in 2010. The distribution of echinococcosis differed in age, sex, ethnicity, occupation and regions in Qinghai（P0.05）. GLMM analysis revealed that gender（female vs. male）, ethnicity（Tibetan vs. other ethnicities）, profession（herders vs. other professions） and region（autonomous prefectures vs. cities） were significant risk factors for echinococcosis（P0.05）. It was concluded that the prevalence of echinococcosis in 2010 was about 4% in Qinghai province, and the distribution of echinococcosis in Qinghai was associated with age, sex, ethnicity and profession.展开更多
BACKGROUND Radical resection is an important treatment method for hepatic echinococcosis.The posterosuperior segments of the liver remain the most challenging region for laparoscopic or robotic hepatectomy.AIM To demo...BACKGROUND Radical resection is an important treatment method for hepatic echinococcosis.The posterosuperior segments of the liver remain the most challenging region for laparoscopic or robotic hepatectomy.AIM To demonstrate the safety and preliminary experience of robotic radical resection of cystic and alveolar echinococcosis in posterosuperior liver segments.METHODS A retrospective analysis was conducted on the clinical data of 5 patients with a median age of 37 years(21-56 years)with cystic and alveolar echinococcosis in difficult liver lesions admitted to two centers from September to December 2019.The surgical methods included total pericystectomy,segmental hepatectomy,or hemihepatectomy.RESULTS Among the 5 patients,4 presented with cystic echinococcosis and 1 presented with alveolar echinococcosis,all of whom underwent robotic radical operation successfully without conversion to laparotomy.Total caudate lobectomy was performed in 2 cases,hepatectomy of segment Ⅶ in 1 case,total pericystectomy of segment Ⅷ in 1 case,and right hemihepatectomy in 1 case.Operation time was 225 min(175-300 min);blood loss was 100 mL(50-600 mL);and postoperative hospital stay duration was 10 d(5-19 d).The Clavien-Dindo complication grade was Ⅰ in 4 cases and Ⅱ in 1 case.No recurrence of echinococcosis was found in any patient at the 3 mo of follow-up.CONCLUSION Robotic radical surgery for cystic and selected alveolar echinococcosis in posterosuperior liver segments is safe and feasible.展开更多
目的研究正常成年人水平特异性CE-Chirp(level specific CE-Chirp,CE-Chirp LS)刺激声与Click刺激声诱发听性脑干反应(auditory brainstem response,ABR)反应阈与纯音听阈的关系及在不同声强下两种刺激声所诱发的ABR波形特点,探讨CE-Chi...目的研究正常成年人水平特异性CE-Chirp(level specific CE-Chirp,CE-Chirp LS)刺激声与Click刺激声诱发听性脑干反应(auditory brainstem response,ABR)反应阈与纯音听阈的关系及在不同声强下两种刺激声所诱发的ABR波形特点,探讨CE-Chirp LS声诱发的ABR在听觉功能客观评估中的应用价值。方法选择正常成年人21例(共42耳)分别在0.5、1.0、2.0、4.0 kHz进行纯音气导听阈测试,获取其双耳各频率的纯音听阈,分别采用CEChirp LS刺激声与Click刺激声诱发ABR,测量2种刺激声在80、60、40 dB nHL的Ⅴ波波幅,获得2种刺激声下受试者的Ⅴ波反应阈,获取其在80 dB nHL刺激强度时Ⅰ、Ⅲ、Ⅴ波潜伏期。按照自身对照的方法对相同刺激强度下2种刺激声诱发的ABR潜伏期及波幅差异性进行统计分析,比较2种刺激声下Ⅴ波反应阈与纯音听阈差值。结果正常成年人80、60、40 dB nHL刺激强度下,CE-Chirp LS刺激声诱发的ABR的Ⅴ波波幅均大于Click刺激声,差异有统计学意义(P<0.001);CE-Chirp LS刺激声诱发的ABR的V波反应阈与纯音平均听阈差值均低于Click刺激声,差异有统计学意义(P<0.05);80 dB nHL声强下CE-Chirp LS刺激声Ⅰ波潜伏期长于Click刺激声,差异有统计学意义(P<0.001),CE-Chirp LS刺激声Ⅲ、Ⅴ波潜伏期与Click刺激声比较,差异无统计学意义(P>0.05)。结论正常成年人CE-Chirp LS刺激声与Click刺激声比较,无论在高强度还是低强度刺激下波幅均明显增大,Ⅴ波反应阈更接近于纯音听阈,更有利于纯音听阈判定,但潜伏期个体差异更大。展开更多
文摘BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices.One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.
基金Supported by National Natural Science Foundation of China,No.82260412.
文摘BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.
文摘BACKGROUND Human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The coexistence of CE and HCC is exceedingly rare,and only several well-documented cases have been reported.In addition to this coexistence,there is no report of the coexistence of CE,HCC,and liver abscess to date.Herein,we aimed to report a case of coexistence of liver abscess,hepatic CE,and HCC.CASE SUMMARY A 65-year-old herdsman presented to the department of interventional therapy with jaundice,right upper abdominal distension and pain for 10 d.Laboratory test showed that he had positive results for HBsAg,HBeAb,HBcAb,and echino-coccosis IgG antibody.The test also showed an increased level of alpha fetopro-tein of 3400 ng/mL.An abdominal computed tomography(CT)scan revealed an uneven enhanced lesion of the liver at the arterial phase with enhancement and was located S4/8 segment of the liver.In addition,CT scan also revealed a mass in the S6 segment of the liver with a thick calcified wall and according to current guideline and medical images,the diagnoses of hepatic CE(CE4 subtype)and HCC were established.Initially,transarterial chemoembolization was performed for HCC.In the follow-up,liver abscess occurred in addition to CE and HCC;thus,percutaneous liver puncture drainage was performed.In the next follow-up,CE and HCC were stable.The liver abscess was completely resolved,and the patient was discharged with no evidence of recurrence.CONCLUSION This is the first reported case on the coexistence of liver abscess,hepatic CE,and HCC.Individualized treatment and multidisciplinary discussions should be performed in this setting.Therefore,treatment and diagnosis should be based on the characteristics of liver abscess,hepatic CE,and HCC,and in future clinical work,it is necessary to be aware of the possibility of this complex composition of liver diseases.
基金2021-2022 Qinghai Province“Kunlun Talents”Action Plan of Young and Middle-Aged Scientific and Technological Talents.
文摘Objective:To comprehend the clinical characteristics and treatment approaches for children and adolescents in Qinghai Province with two types of echinococcosis,cystic echinococcosis(CE)and alveolar echinococcosis(AE).Methods:A total of 128 pediatric inpatients with echinococcosis at the People’s Hospital of Qinghai Province and the Clinical Research Institute of Echinococcosis of Qinghai Province between January 2016 and December 2021 were chosen as subjects.Demographic and clinical data were collected,and double data entry was executed using EpiData 3.02.Factors influencing the cure of echinococcosis were analyzed with echinococcosis cure as the dependent variable,employing statistical analysis via SPSS 19.0.Results:Of the cases,35.9%had CE,and 64.1%had AE.Both types were observed in patients of all ages,with the majority aged 13-18.The number of cysts and their sizes varied between CE and AE.Complications were prevalent,including liver,gallbladder,lung,and nutritional complications.Univariate analyses revealed significant differences in outcomes based on factors such as cyst size(for CE),liver function grade(for AE),hydatid hypersensitivity test,operation,and length of hospital stay(P<0.05).Conclusion:This comprehensive analysis of hospitalized cases sheds light on the clinical data of echinococcosis in children and adolescents in Qinghai Province.The findings contribute to a scientific foundation for formulating effective prevention and control measures tailored to this demographic,facilitating an improved understanding of echinococcosis in Qinghai province.
文摘Hepatic echinococcosis, also called echinococcosis, is a health-threatening disease commonly found in pasture, and belongs to parasitic zoonoses. The purpose of this study was to investigate the prevalence and the risk factors of echinococcosis in Qinghai province in order to provide fundamental data for prevention and control of echinococcosis in Qinghai province. A total of 23 445 people from 21 counties were enrolled in this study by multi-stage stratified random sampling. Echinococcosis was diagnosed by using B-mode ultrasonography and serological tests. The results showed that the prevalence of echinococcosis was 4.47%（95%CI： 4.21%–4.73%） and serum positive rate（seroprevalence） was 15.47%（95%CI： 14.92%–16.02%） in 2010. The distribution of echinococcosis differed in age, sex, ethnicity, occupation and regions in Qinghai（P0.05）. GLMM analysis revealed that gender（female vs. male）, ethnicity（Tibetan vs. other ethnicities）, profession（herders vs. other professions） and region（autonomous prefectures vs. cities） were significant risk factors for echinococcosis（P0.05）. It was concluded that the prevalence of echinococcosis in 2010 was about 4% in Qinghai province, and the distribution of echinococcosis in Qinghai was associated with age, sex, ethnicity and profession.
文摘BACKGROUND Radical resection is an important treatment method for hepatic echinococcosis.The posterosuperior segments of the liver remain the most challenging region for laparoscopic or robotic hepatectomy.AIM To demonstrate the safety and preliminary experience of robotic radical resection of cystic and alveolar echinococcosis in posterosuperior liver segments.METHODS A retrospective analysis was conducted on the clinical data of 5 patients with a median age of 37 years(21-56 years)with cystic and alveolar echinococcosis in difficult liver lesions admitted to two centers from September to December 2019.The surgical methods included total pericystectomy,segmental hepatectomy,or hemihepatectomy.RESULTS Among the 5 patients,4 presented with cystic echinococcosis and 1 presented with alveolar echinococcosis,all of whom underwent robotic radical operation successfully without conversion to laparotomy.Total caudate lobectomy was performed in 2 cases,hepatectomy of segment Ⅶ in 1 case,total pericystectomy of segment Ⅷ in 1 case,and right hemihepatectomy in 1 case.Operation time was 225 min(175-300 min);blood loss was 100 mL(50-600 mL);and postoperative hospital stay duration was 10 d(5-19 d).The Clavien-Dindo complication grade was Ⅰ in 4 cases and Ⅱ in 1 case.No recurrence of echinococcosis was found in any patient at the 3 mo of follow-up.CONCLUSION Robotic radical surgery for cystic and selected alveolar echinococcosis in posterosuperior liver segments is safe and feasible.
文摘目的研究正常成年人水平特异性CE-Chirp(level specific CE-Chirp,CE-Chirp LS)刺激声与Click刺激声诱发听性脑干反应(auditory brainstem response,ABR)反应阈与纯音听阈的关系及在不同声强下两种刺激声所诱发的ABR波形特点,探讨CE-Chirp LS声诱发的ABR在听觉功能客观评估中的应用价值。方法选择正常成年人21例(共42耳)分别在0.5、1.0、2.0、4.0 kHz进行纯音气导听阈测试,获取其双耳各频率的纯音听阈,分别采用CEChirp LS刺激声与Click刺激声诱发ABR,测量2种刺激声在80、60、40 dB nHL的Ⅴ波波幅,获得2种刺激声下受试者的Ⅴ波反应阈,获取其在80 dB nHL刺激强度时Ⅰ、Ⅲ、Ⅴ波潜伏期。按照自身对照的方法对相同刺激强度下2种刺激声诱发的ABR潜伏期及波幅差异性进行统计分析,比较2种刺激声下Ⅴ波反应阈与纯音听阈差值。结果正常成年人80、60、40 dB nHL刺激强度下,CE-Chirp LS刺激声诱发的ABR的Ⅴ波波幅均大于Click刺激声,差异有统计学意义(P<0.001);CE-Chirp LS刺激声诱发的ABR的V波反应阈与纯音平均听阈差值均低于Click刺激声,差异有统计学意义(P<0.05);80 dB nHL声强下CE-Chirp LS刺激声Ⅰ波潜伏期长于Click刺激声,差异有统计学意义(P<0.001),CE-Chirp LS刺激声Ⅲ、Ⅴ波潜伏期与Click刺激声比较,差异无统计学意义(P>0.05)。结论正常成年人CE-Chirp LS刺激声与Click刺激声比较,无论在高强度还是低强度刺激下波幅均明显增大,Ⅴ波反应阈更接近于纯音听阈,更有利于纯音听阈判定,但潜伏期个体差异更大。
